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目的评估急性自发性脑内出血患者并发消化道出血的发生率、严重度及风险预测指标。方法对125例急性自发性脑内出血患者资料采用回顾性病例-对照研究,结果变量为消化道出血。将一系列参数行单因素分析后做多因素logistic回归分析。结果单因素分析中:年龄,GCS评分,瞳孔不等,平均动脉压,血糖,脑室出血,血肿大小,占位效应,脑积水,凝血酶时间,开颅血肿清除术与消化道出血相关。多因素logistic回归分析表明独立的风险预测指标包括GCS评分低(P<0.001),血肿≥30 ml(P=0.017),累及脑室出血(P=0.018),开颅血肿清除术(P=0.043)。结论GCS评分低,血肿大,脑室出血及手术创伤是增加急性自发性脑内出血患者并发消化道出血风险的重要因素。
Objective To evaluate the incidence, severity and prediction of risk of gastrointestinal bleeding in patients with acute spontaneous intracerebral hemorrhage. Methods A retrospective case-control study was conducted in 125 patients with acute idiopathic intracerebral hemorrhage. The result was gastrointestinal bleeding. A series of parameters were univariate analysis of multivariate logistic regression analysis. Results In the univariate analysis, age, GCS score, pupil range, mean arterial pressure, blood glucose, ventricular hemorrhage, hematoma size, mass effect, hydrocephalus, thrombin time and craniotomy were associated with gastrointestinal bleeding. Multivariate logistic regression analysis showed that the independent predictors of risk included low GCS score (P <0.001), hematoma ≥30 ml (P = 0.017), intracerebral hemorrhage (P = 0.018), and craniotomy (P = 0.043) . Conclusion The low GCS score, hematoma, ventricular hemorrhage and surgical trauma are the important factors that increase the risk of gastrointestinal bleeding in patients with acute spontaneous intracerebral hemorrhage.